儿童先天性肺囊性病胸腔镜手术的围手术期并发症

目的:分析儿童先天性肺囊性病胸腔镜手术围手术期并发症的原因，讨论降低并发症发生率的方法。方法:收集2012年5月至2019年12月于北京儿童医院胸外科进行胸腔镜手术的672例肺囊性病患儿的病例资料。其中，男418例，女254例；中位手术年龄为14个月，手术年龄范围为1~189个月。手术方式根据病变范围选择肺叶切除或肺段...

Perioperative complications of thoracoscopy for congenital pulmonary cystic disease in children

Objective To explore the causes of perioperative complications in children with congenital pulmonary cystic disease undergoing thoracoscopy and discuss the methods of reducing the complications.Methods From May 2012 to December 2019,clinical data were collected from 672 children with pulmonary cystic disease undergoing thoracoscopy.There were 418 boys and 254 girls with a median operative age of 14(1-189)months.The surgical approach of lobectomy or segmentectomy was selected according to disease extent.Postoperative routine electrocardiography(ECG)monitoring,percutaneous blood oxygen monitoring and low-flow oxygen inhalation for 24 h were implemented;a normal diet resumed at postoperative 6h;routine use of antibiotics based upon blood routine and clinical manifestations for adjusting medication;when drainage tube volume<50 ml/d,chest radiology indicated excellent pulmonary recruitment and there was no pneumothorax or effusion after removing thoracic drainage tube.Results All operations were successful.The median operative duration was 56(10-260)min and the median intraoperative volume of blood loss 2(1-100)ml.Intraoperative hemorrhage(n=5,0.7%),lymphatic leakage(n=1,0.1%)and tracheal injury(n=1,0.1%)occurred.And there were postoperative onsets of chylothorax(n=2,0.3%),Horner syndrome(n=2,0.3%)(including 1 case with diaphragmatic elevation at operated side),atelectasis(n=2,0.3%),postoperative persistent air leakage(n=2,0.3%)and residual lesions(n=3,0.4%).Conclusions Thoracoscopy is both safe and effective for congenital cystic disease in children.The risk of perioperative complications should be fully assessed and postoperative complications recognized early and managed promptly.